European Journal of Molecular & Clinical Medicine

Abstract

Background: The anterior abdominal wall hernia is commonly encountered in surgical practice. When they present as complicated hernia, the complication, morbidity, and mortality are high even after standard protocol management. The present study was undertaken to assess the incidence of irreducible hernias presenting with complications, mode of clinical presentation and management of irreducible hernia.
Method: During the study period from May 2019 to Nov 2021, a total 53 clinically diagnosed case of irreducible hernia were studied which included groin hernia (66.6%) and anterior abdominal wall hernia [incisional hernia (22.6%), umbilical (1.88%), epigastric (1.88%), paraumbilical (3.9%)].
Results: The incidence of irreducible hernia was 3.2% (1650/53). Duration of existing hernia was common in 86.7% cases after 1-year. Maximum cases (74.8%) presented within 24-hours of onset of symptoms. The commonest symptoms were irreducible swelling (100%) and pain (85%). Maximum (52.8%) cases presented with bowel obstruction as complication. Cause of irreducibility was neck of hernial sac (56%) and adhesions (43.4%). Commonest operative procedure was release of constriction (56.6%) and adhesiolysis (43.3%). 56.6% cases developed post-operative complications and surgical site infections (SSI) was the commonest one (33.9%). No recurrence found during the study period. 3(5.6%) patients were expired, 2 patients died because of septicaemia secondary to anastomosis leak and 1 case ARDS. Conclusion: The present study clearly shows longer duration of existing hernia, existing co-morbidities, delay in operation in irreducible hernia is associated with definite complications and mortality. Hence, earlier hernia repair and not wasting crucial time when patient of irreducible hernia comes to hospital.